| NPI | 1316507676 |
|---|---|
| Former Name | NICOLE GENEVIEVE THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA 1886) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NM CTB-2024-0596) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2025-05-14 |